In South Africa, a National Coronavirus Command Council (NCCC) has been established in terms of the Disaster Management Act and placed under the leadership of President Cyril Ramaphosa. It is remarkable that a political institution is established to manage scientific issues. Our scientific communities have well-established methods and protocols in place to analyse and distill the best answers to the most complex scientific questions, without political interference. Human survival and development have largely relied on these communities, methods and protocols for thousands of years – with politics often getting in the way. When it comes to deciding which medical procedure is best for a patient, doctors do not consult with politicians, and the final decision is not a democratic one, but the one with the best logical argument and empirical evidence in consultation with the patient.
One of the NCCC’s first decisions was to declare a nationwide lockdown from 26 March – initially planned until 16 April, but as of the time of writing extended until further notice. While the first phase of the lockdown included a total shutdown of all commercial and social activity, enforced by the nation’s army and policy force, minor relaxations were announced with the introduction of a new level (4) on 1 May 2020. International media have referred to South Africa’s lockdown as one of the strictest, most invasive, in the world, while the World Health Organisation praised our efforts to curb the spread of Covid-19.
The lockdown was necessary, urgent and well argued. South Africa’s health care system was not prepared, and the extra time bought with the lockdown allowed hospitals to get the necessary equipment in place and staff to be trained. Also, South Africa’s high number of people with TB, diabetes and HIV, as well as people living in dire poverty, warrants extra caution.
However, it seems difficult to ascertain whether the lockdown has successfully accomplished its goals. Official reports in the media indicate that the lockdown has delayed, not averted, a peak in infections. A severe shortage of ICU beds remains, and detailed data on the people that have died, and in which conditions they have died, remains sketchy. It seems therefore that all the lockdown has done, is to buy us time. Question is whether that time has been put to its best use.
We have now moved into a new phase of balancing the need, and efficiency, of physically keeping people apart from one another and away from contagious areas on the one hand, and preventing the nation’s economy from irreparable damage on the other hand. Some people, armed with mathematical models from the actuarial science, claim that a severely damaged economy is already hurting more people than the pandemic does, or ever would.
At least some of the issues seem to me to come down to a question of risk calculation. Some people seem willing to take a risk, as long as that risk is calculated and low. If there is only a one in ten chance that one would get infected by going back to work, or to school, and of those infected only one in one hundred dies, then people may as well take that chance. Or if data shows that the elderly, that do not or hardly contribute to the economy, are most at risk, while the working population is at much lower risk, it makes sense to keep the latter at work, boost the economy, and focus on the protection of the elderly. Or if certain areas are more infected, it makes sense to focus on these areas. Other people, however, seem to draw a much broader line with much less refinement, in an attempt to not only minimise but entirely eradicate any risk. They aim for zero risk, and for a zero chance of infection. Would it be right to say that the former are pragmatists, and the latter idealists?
There is a lot of confusion, not in the least because few people in leadership positions have the luxury to sit down and carefully think this through. Rather, they find themselves on a moving train, filled with people demanding to know where the train is headed, and when we’ll get there. Thing is, no one knows. The frustrating thing is, the people also know this, but that doesn’t stop them from demanding answers.
We may not know where we’re heading, but as a society, we never do, and never did. Humanity always adapted to whatever was thrown at it. Who saw the internet coming? Nine/Eleven? Designer babies? So asking where we’re headed now, seems futile and more importantly, unnecessary. Why ask this question now, if you’ve never wondered about it before? But while this question may go unanswered, others don’t need to.
And then … President Ramaphosa, in his speech to the nation on 13 May 2020, states that the NCCC is guided by international experts, experience and data. The President lists a number of arguments to explain why the lockdown was necessary. But most of all, the President wants us to sit back and trust his, and the NCCC’s, judgement. And do as we’re told, for which he is very grateful indeed.
It is irrelevant whether I agree with the current decisions to strictly control the spread of Covid-19 or not – as a matter of fact, I do agree with most – but it is fundamentally relevant that the data and arguments that lead up to those decisions, are open for scrutiny. After all, the NCCC, or the President, and I, may be wrong. For the President to state that mistakes have been made, and will be made, without spelling out what these mistakes are or how they will be addressed and corrected, is an empty statement. It means nothing.
There is only one good way to reply to criticism, and there are many bad ways. The bad ways include demanding to be blindly trusted, invoking authority, fear, faith and democratic majority. The only good way is to enter into an open, rational dialogue, and expose the arguments that lead to decisions. To claim that this dialogue is taking place behind closed doors, with people that cannot be named and data that cannot be revealed, is defying the very definition of dialogue.